Provider Demographics
NPI:1417248998
Name:KING, YAPHETT
Entity Type:Individual
Prefix:MR
First Name:YAPHETT
Middle Name:
Last Name:KING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6716 LYREWOOD LN
Mailing Address - Street 2:APT.76
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73132-6315
Mailing Address - Country:US
Mailing Address - Phone:727-420-7255
Mailing Address - Fax:
Practice Address - Street 1:6716 LYREWOOD LN
Practice Address - Street 2:APT.76
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73132-6315
Practice Address - Country:US
Practice Address - Phone:727-420-7255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-02
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health